indication

Vecuronium is a muscle relaxing agent and is used as an ajunct in general anesthesia.

pharmacology

Vecuronium operates by competing for the cholinoceptors at the motor end plate thereby exerting its muscle-relaxing properties which are used adjunctively to general anesthesia.

mechanism of action

Vecuronium is a bisquaternary nitrogen compound that acts by competitively binding to nicotinic cholinergic receptors. The binding of vecuronium decreases the opportunity for acetylcholine to bind to the nicotinic receptor at the postjunctional membrane of the myoneural junction. As a result, depolarization is prevented, calcium ions are not released and muscle contraction does not occur.

biotransformation

100%

half life

51–80 minutes

route of elimination

Fecal (40-75%) and renal (30% as unchanged drug and metabolites)

drug interactions

Amikacin: The agent increases the effect of muscle relaxant

Aminophylline: Theophylline decreases the effect of muscle relaxant

Azathioprine: The agent decreases the effect of the muscle relaxant

Betamethasone: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Betamethasone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Carbamazepine: Decreases the effect of muscle relaxant

Clindamycin: The agent increases the effect of muscle relaxant

Colistimethate: Colistimethate may increase the neuromuscular blocking action of Vecuronium. Risk of respiratory depression and apnea. Consider alternate therapy or monitor for prolonged neuromuscular blocking effects, such as respiratory paralysis.

Corticotropin: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Corticotropin. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Cortisone acetate: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Cortisone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Dexamethasone: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Dexamethasone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Fludrocortisone: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Fludrocortisone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Fosphenytoin: Phenytoin decreases the effect of muscle relaxant

Gentamicin: The agent increases the effect of muscle relaxant

Hydrocortisone: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Hydrocortisone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Lincomycin: The agent increases the effect of muscle relaxant

Mercaptopurine: The agent dereases the effect of the muscle relaxant

Methylprednisolone: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Methylprednisolone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Netilmicin: The agent increases the effect of muscle relaxant

Oxtriphylline: Theophylline decreases the effect of muscle relaxant

Phenytoin: Phenytoin decreases the effect of the muscle relaxant

Piperacillin: The agent increases the effect of the muscle relaxant

Polymyxin B Sulfate: Polymyxin B may increase the neuromuscular blocking action of Vecuronium. Risk of respiratory depression and apnea. Consider alternate therapy or monitor for prolonged neuromuscular blocking effects, such as respiratory paralysis.

Prednisolone: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Prednisolone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Prednisone: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Prednisone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Quinidine: The quinine derivative increases the effect of the muscle relaxant

Quinine: Quinine may increase the neuromuscular blocking action of Vecuronium. Risk of respiratory depression and apnea. Concurrent therapy should be avoided.

Theophylline: Theophylline decreases the effect of the muscle relaxant

Tobramycin: The agent increases the effect of the muscle relaxant

Triamcinolone: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Triamcinolone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.